Long Overdue FDA Action on Agricultural Antibiotics Still Unlikely to Protect Your Health...

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Antibiotic-resistant disease is a major threat to public health, and the primary cause for this is the widespread misuse of antibiotics—primarily in agriculture

According to a landmark report by the CDC, two million American adults and children become infected with antibiotic-resistant bacteria each year, and at least 23,000 of them die as a direct result of those infections

In December, the FDA issued a long-awaited guidance on agricultural antibiotics. Unfortunately, it’s unlikely to have a major impact in terms of protecting human health

The FDA is asking drug companies to voluntarily restrict the use of antibiotics that are important in human medicine by excluding growth promotion in animals as a listed use on the drug label

Researchers also propose implementing a user fee on non-human uses of antibiotics as a way to curtail their misuse

Antibiotic-resistant disease is a major threat to public health, and the primary cause for this man-made epidemic is the widespread misuse of antibiotics—primarily in agriculture.

In fact, while the US Food and Drug Administration (FDA) focuses its attention on minor aspects of the problem, such as the use of antibacterial soaps, it continues to ignore the elephant in the room, namely factory farming practices where antibiotics are routinely fed to animals to promote growth.

Animals such as cattle and chickens are often fed antibiotics at low doses for disease prevention and growth promotion, and those antibiotics are transferred to you via meat, and even via the manure used as crop fertilizer. Agricultural uses of antibiotics actually account for about 80 percent of all antibiotic use in the US,1 so it's undoubtedly a major source of human antibiotic consumption.

CAFOs Promote Antibiotic-Resistant Disease

Chicken confined animal feeding operations (CAFOs) took root in the 1950s, followed by cattle and hog CAFOs in the 1970s and ‘80s respectively. Today, CAFOs dominate all livestock and poultry production in the US.

The intensive animal farming methods of today were developed to increase food production while pushing down prices. And while successful in that respect, it has given rise to a number of significant problems that probably were not considered at the outset—drug-resistant disease being one of them.

Experts have been warning about the implications of antibiotic resistance for years, but never before have their warnings been as emphatic as they are now. Dr. Arjun Srinivasan, associate director of the US Centers for Disease Control and Prevention (CDC) recently told PBS Frontline:2

“For a long time, there have been newspaper stories and magazine articles that asked 'The end of antibiotics?’ Well, now I would say you can change the title to 'The end of antibiotics, period.'"

As reported by Scientific American,3 the FDA issued its long-awaited guidance on agricultural antibiotics on December 11, 2013. Unfortunately, it’s unlikely to have a major impact in terms of protecting your health.

If you can possibly imagine this, the agency is asking drug companies to voluntarily restrict the use of antibiotics that are important in human medicine by excluding growth promotion in animals as a listed use on the drug label.4 This would prevent farmers from legally using antibiotics such as tetracyclines, penicillins,and azithromycin for growth promotion purposes.

Still there are plenty of loopholes. Farmers would still be allowed to use antibiotics for therapeutic purposes, which would allow them plenty of wiggle room to continue feeding their animals antibiotics for growth promotion without actually admitting that’s the reason for doing so. As reported by the featured article:5

“[T]he success of the FDA’s new program depends on how many companies volunteer to change their labels over the next 90 days in alignment with the FDA cutoff period. (Companies that do change their labels will have three years to phase in the changes.) And then there are myriad questions about how this would be enforced on the farm.”

Another proposed amendment to the FDA’s animal drug regulations (the veterinary feed directive)6 would require farmers to obtain a veterinary prescription before using antibiotics in animal feed for any reason.

If this amendment makes it through the comment period intact, it might have a far greater impact. Comments on the proposed rule are being accepted until March 12, 2014. (For instructions on submitting comments, please see the Federal Register page7.)

Non-Human Uses of Antibiotics Have Little to No Value

In related news, a group of researchers propose implementing a user fee on non-human uses of antibiotics as a way to curtail their misuse.8 The paper, titled “Preserving Antibiotics, Rationally,” was published in the New England Journal of Medicine9 on December 26, 2013. According to lead author Aidan Hollis, PhD:10

“Modern medicine relies on antibiotics to kill off bacterial infections. This is incredibly important. Without effective antibiotics, any surgery – even minor ones – will become extremely risky... Ordinary infections will kill otherwise healthy people. Bacteria that can effectively resist antibiotics will thrive, reproducing rapidly and spreading in various ways...

If you become infected with resistant bacteria, antibiotics won't provide any relief. While the vast majority of antibiotic use has gone towards increasing productivity in agriculture, Hollis asserts that most of these applications are of ‘low value.’

"It's about increasing the efficiency of food so you can reduce the amount of grain you feed the cattle. It's about giving antibiotics to baby chicks because it reduces the likelihood that they're going to get sick when you cram them together in unsanitary conditions. These methods are obviously profitable to the farmers, but that doesn't mean it's generating a huge benefit. In fact, the profitability is usually quite marginal. The real value of antibiotics is saving people from dying. Everything else is trivial." [Emphasis mine]

23,000 Americans Die from Antibiotic-Resistant Superbugs Each Year

According to a landmark “Antibiotic Resistance Threat Report” published by the CDC11 in October 2013, two million American adults and children become infected with antibiotic-resistant bacteria each year, and at least 23,000 of them die as a direct result of those infections. Even more die from complications. The resulting cost to the US health care system? A staggering $17-26 billion annually.

According to the Infectious Disease Society of America (IDSA), just one organism—methicillin-resistant Staphylococcus aureus, better known as MRSA—kills more Americans each year than the combined total of emphysema, HIV/AIDS, Parkinson’s disease, and homicide.12 This death toll is really just an estimate, and the real number is likely much higher. The true extent of superbug infections remains unknown because no one is tracking them—at least not in the US.

Hospitals here are not required to report outbreaks of antibiotic-resistant bacteria, unlike in the EU where they are at least making efforts to track them. The US is in desperate need of a surveillance program for reporting and tracking this growing threat.13 But what we’re seeing is the evolution of bacteria. Basically, microorganisms have learned to teach each other how to outsmart the best pharmaceutical drugs we have to offer, and they are winning the battle.

The Price You Pay for Cheap Chicken...

Consumer Reports14 also issued a December 2013 report on this issue, revealing that a whopping 97 percent of all chicken sampled across the US harbored serious disease-causing bacteria, many of which are resistant to antibiotics. According to the article:

“It’s unrealistic to expect that the uncooked chicken you buy won’t contain any potentially harmful bacteria. That’s one reason we advise you to prevent raw chicken or its juices from touching any other food and to cook it to at least 165˚ F...Yet some bacteria are more worrisome than others—and our latest tests produced troubling findings. More than half of the samples contained fecal contaminants. And about half of them harbored at least one bacterium that was resistant to three or more commonly prescribed antibiotics.”[Emphasis mine}

Last October, a nationwide salmonella outbreak15 occurred, courtesy of infected chicken originating from Foster Farms. The antibiotic-resistant strain of salmonella, known as Heidelberg, sickened close to 300 people in 17 states. Of those infected, 40 percent required hospitalization—twice as many people as typically require hospitalization due to regular salmonella. So what can you do to protect yourself and your family from this scourge? According to Consumer Reports:

“’Our tests did not find brands or types of chicken breasts that had less bacteria than the rest. At the moment, the only way to protect yourself from becoming sick is to remain vigilant about safe handling and cooking... Still, there are good reasons for selecting chickens raised without the use of antibiotics. Buying those products supports farmers who keep their chickens off unnecessary drugs, and that’s good for your health and preserves the effectiveness of antibiotics. Chickens without antibiotic resistance to salmonella and other dangerous pathogens can’t pass antibiotic-resistant bugs on to you,’ says Robert Lawrence, M.D., the Center for a Livable Future Professor at the Johns Hopkins Bloomberg School of Public Health.”

Beware: Antibacterial Soaps Also Do More Harm Than Good

As I have warned for many years, antibacterial wipes, creams, and soaps are frequently promoted as the answer to preventing the spread of potentially harmful bacteria. Two of the most widely used antibacterial compounds, triclosan and triclocarban, have been added to countless products, from chopping boards to mattresses, in an attempt to halt the spread of microbes. Unfortunately, such products are actually part of the problem, as they too promote antibiotic-resistance.

Triclosan, for example, does kill weaker bacteria but actually favors more tolerant species. It also tends to promote the growth of lineages of bacteria that are already resistant to the oral antibiotics used in hospitals, thereby strengthening their resistance. What’s more, studies show that these antibiotic chemicals are no more likely than regular soap to prevent illness,16 so using them is likely to do far more harm than good. In fact, for chronically sick patients, antibiotic soaps have been found to be associated with increases in the frequencies of fevers, runny noses, and coughs.

The CDC began warning against the widespread use of triclosan over a decade ago.17 In a presentation at the 2000 Emerging Infectious Diseases Conference in Atlanta, Georgia, Stuart B. Levy fromTufts University School of Medicine stated:

“The antibacterial substances added to diverse household cleaning products are similar to antibiotics in many ways. When used correctly, they inhibit bacterial growth. However, their purpose is not to cure disease but to prevent transmission of disease-causing microorganisms to non-infected persons. Like antibiotics, these products can select resistant strains and, therefore, overuse in the home can be expected to propagate resistant microbial variants.

How to Properly Wash Your Hands to Stop Spread of Infection

Getting back to basics is often the best advice, and that definitely applies here. Good old-fashioned hand washing with plain soap and water is one of the oldest and most powerful antibacterial treatments there is; no harsh disinfectants or microbial soaps required. What you do need, however, is proper hand washing technique. To make sure you’re actually removing the germs when you wash your hands, follow these guidelines:

Use lukewarm water. (Hot water doesn’t kill bacteria better than cooler water when it comes to handwashing, but wastes exorbitant amounts of energy. According to one recent study,18 the energy Americans waste each year simply by washing their hands in hot water is equivalent to the total annual fuel use of Barbados.)

Use a mild soap

Work up a good lather, all the way up to your wrists, for at least 10 or 15 seconds

Make sure you cover all surfaces, including the backs of your hands, wrists, between your fingers, and around and below your fingernails

Rinse thoroughly under running water

In public places, use a paper towel to open the door as a protection from germs that the handles may harbor

Also remember that your skin itself is actually your primary defense against bacteria--not the soap. So there’s no need to become obsessive about washing your hands. Washing too vigorously or too frequently can actually extract many of the protective oils in your skin. This can cause your skin to crack and potentially even bleed, providing germs a point of entry into your body where they can do more harm.

Help Stop the Spread of Antibiotic-Resistant Disease

There are a number of ways you can help curtail the growth and spread of antibiotic-resistant bacteria. This includes:

Using antibiotics only when absolutely necessary

Avoiding antibacterial household products

Properly washing your hands to stop the spread of infection

Purchasing organic, antibiotic-free meats and other foods

Reducing the spread of antibiotic-resistant bacteria is a significant reason for making sure you're only eating grass-fed, organically-raised meats and animal products. Besides growing and raising your own, buying your food from responsible, high-quality, sustainable sources is your best bet, and I strongly encourage you to support the small family farms in your area. While the problem of antibiotic-resistance really needs to be stemmed through public policy on a nationwide level, the more people who get involved on a personal level to stop unnecessary antibiotic use, the better.

So please, remember that not every bacterial infection needs to be treated with a drug. First, as an all-around preventive measure, you’ll want to make sure your vitamin D level is optimized year-round, especially during pregnancy, along with vitamin K2. A number of other natural compounds can also help boost your immune system function to help rid you of an infection, including:

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If you want to use an article on your site please click here. This content may be copied in full, with copyright, contact, creation and information intact, without specific permission, when used only in a not-for-profit format. If any other use is desired, permission in writing from Dr. Mercola is required.

Disclaimer: The entire contents of this website are based upon the opinions of Dr. Mercola, unless otherwise noted. Individual articles are based upon the opinions of the respective author, who retains copyright as marked. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Mercola and his community. Dr. Mercola encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional. If you are pregnant, nursing, taking medication, or have a medical condition, consult your health care professional before using products based on this content.

If you want to use an article on your site please click here. This content may be copied in full, with copyright, contact, creation and information intact, without specific permission, when used only in a not-for-profit format. If any other use is desired, permission in writing from Dr. Mercola is required.